The eyes of a neonate
are normally examined for such problems as congenital
glaucoma and congenital cataracts .
However, children can suffer from many different kinds of vision problems
that can seriously affect their development in other areas. There is a
long list of illnesses and injuries that can cause vision problems. Sometimes
the damage is in the eye itself and sometimes it's in the part of the
brain that receives messages for sight. When a baby is born with severe
vision problems or blindness, the cause is often one of the following:

As children grow, some of the most common vision problems seen by parents
are crossed eyes , cataracts
and nearsightedness . Other eye problems include
conjunctivitis and severe
bacterial eye infections (such as periorbital cellulitis ,
and orbital cellulitis .

Amblyopia (crossed eyes) describes below
normal vision in one or both eyes. It may stem from visual problems
early in life that result in developmental disorders such as uncorrected
difference in visual acuity between each of the two eyes ( lazy
eye ) or misalignment of the eyes ( strabismus ).
Amblyopia is a common condition that affects approximately 4% of children
before age 6. Untreated, up to 50% of children with this condition will
develop secondary visual loss. Farsightedness, nearsightedness, astigmatism
and cataracts can also result in amblyopia.
In amblyopia, the strong eye becomes dominant and maintains good vision
while the weak eye fails to develop a clear visual image. An infant
and toddler up to age 3 is at greatest risk, but amblyopia can occur
up to age 9 when full visual stability has been achieved.

Cataracts are dense, cloudy areas in the
lens of a child's eye. The lens is normally clear and its job is to
focus images on the retina (the place at the back of the eye that transforms
images into nerve impulses that travel to the brain). When cataracts
block out parts of the lens, the child's lens cannot focus images clearly
on the retina, and this causes vision problems.
Eye trauma (physical injury to the eye) is one important cause of cataracts
in children. Cataracts are often seen in children who are victims of
child abuse. Steroid medicines can also cause cataracts. So can certain
metabolic diseases .

In nearsightedness , also called myopia ,
a child has problems seeing objects that are far away. Nearsightedness
tends to run in families, and it happens because of a simple physical
problem. In a nearsighted eye, images fall short of the retina and come
out blurry.
Nearsightedness is common in infants, pre-schoolers and in pre-term
infants. A family history also predisposes a child to this condition.
One in five persons needs to wear eyeglasses for nearsightedness. Children
often become nearsighted at about age 12, and their condition may get
worse as they go through their teens. After age 20, their vision usually
stabilises. Farsightedness , also called hyperopia ,
is the reverse of the above. The child has problems seeing objects that
are near. In this condition the visual images fall behind the retina.
A family history of farsightedness is a risk factor.

Diagnosis and Treatment

When a baby is born with eyes that have developed abnormally, the child's
vision can be tested immediately. Ophthalmologists (eye-doctors) use specially
designed vision tests for children who are too young to say how much they
can see. In infants with normally formed eyes, parents can check the child's
vision at home by watching how the baby's eyes follow their faces, a moving
toy or mobile. Remember, all babies are naturally nearsighted until they
are about 3 months old many babies occasionally have crossed eyes as their
eye co-ordination develops until about the same age. However, after the
first 3 months or thereabouts, the baby's eyes should be able to follow
a moving object at a distance of about 20 cm (8 inches) from their face
(for some milestones in a child's first year, go here ).
When children are about 3 years old, they are usually old enough to take
a simple vision test using picture cards.

Children who have cataracts can have surgery to remove the cloudy parts
of their lens. After surgery, any remaining vision problems can usually
be corrected by eyeglasses, contact lenses or special corneal surgery (an
operation on the cornea, the clear outer part of the
eye, just over the dark pupil).

A child with misalignment of the eyes should start treatment before
age 2. For several hours each day, the child wears a patch over the "good"
eye. This forces the "lazy" eye to work harder. Children with severely
crossed eyes sometimes need surgery to shorten the muscles around the
eye. This surgery should bring the crossed eyes back into alignment, but
is also best performed before a child is 2 years old.

Nearsighted children can wear eyeglasses or contact lenses to correct
their vision. Also, a new type of surgery, called radial
keratotomy , is now being used to treat nearsightedness. In radial
keratotomy, small cuts are made in the cornea to flatten its shape and
help correct nearsightedness. Experts are still evaluating the risks and
results of this new surgery. A farsighted child may accommodate to the
condition if it is mild. If more serious, the child may squint, rub her
eyes or be uninterested in reading. Eyeglasses or contact lenses can rectify
the problem.

The information in this page is presented in summarised form and has been taken
from the following source(s):
1.
Intelihealth.com, Children's Health Section: http://www.intelihealth.com/